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Published on: June 2, 2014
The association of opioid use disorder with cerebral aneurysm rupture
Fares Qeadan1, Emma M Federico2, Benjamin Tingey1
1Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA.
Background:
The association between opioid use disorder (OUD) and cerebral aneurysm rupture has been suggested in recent studies. However, these studies are limited to small sample sizes and lack data on medications for opioid use disorder (MOUD). We investigate the association between OUD and cerebral aneurysm rupture in a large database.
Methods:
A retrospective cohort study was conducted using de-identified electronic health record (EHR) data from Oracle EHR Real-World Data™ (OERWD). Cox proportional hazard regressions were conducted to assess the association between OUD and aneurysm rupture, and the association of MOUD with aneurysm rupture, over different years of follow-up.
Results:
Patients with OUD (n = 584,125), compared to non-exposures (n = 1752,375) had 54 % higher risk (adjusted hazard ratio (aHR) [95 % confidence interval (CI)]: 1.54 [1.34, 1.76]) of cerebral aneurysm rupture within one year of follow-up and 28 % higher risk (aHR [95 % CI]: 1.28 [1.14, 1.44]) within five years of follow-up. Additionally, patients with OUD and MOUD treatment (n = 83,164), compared to those with OUD but without MOUD (n = 410,466), had 25 % lower risk (aHR [95 % CI]: 0.75 [0.55, 1.01]) of cerebral aneurysm rupture in one year of follow-up and 30 % lower risk (aHR [95 % CI]: 0.70 [0.51, 0.98]) in five years of follow-up.
Conclusions:
This research identified OUD as a significant risk factor, and MOUD as a protective factor both significant and on the boundary of significance in certain years of follow-up for cerebral aneurysm rupture. These results provide important insight that could encourage future targeted strategies for early intervention and prevention in such patients.
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